Die Anaesthesiologie最新文献

{"title":"[Training and clinical use of focused echocardiography : Evaluation of the state of training and clinical application of perioperative focused echocardiography by anesthesiologists in Germany].","authors":"Timo Kummerow, Pablo Cavalié, Felix Reinecke, Melissa Barroux, Matthias Göpfert, P Scheiermann, R Tomasi","doi":"10.1007/s00101-026-01719-6","DOIUrl":"10.1007/s00101-026-01719-6","url":null,"abstract":"<p><strong>Background: </strong>Focused cardiac ultrasound (FOCUS) is a targeted point-of-care echocardiographic approach for rapid assessment of cardiac function and morphology. It is established in emergency and intensive care medicine and increasingly more relevant for making perioperative decisions. Data on its integration into perioperative workflows by anesthesiologists and on the role of training and supervision, remain limited.</p><p><strong>Objective: </strong>This nationwide survey assessed FOCUS training, supervision and clinical application among anesthesiologists in Germany and examined how training and supervision were associated with self-reported confidence in performing FOCUS and the extent of its clinical use.</p><p><strong>Material and methods: </strong>We conducted an anonymized digital cross-sectional survey among physician members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI). The standardized questionnaire comprised 21 items on professional background, echocardiographic training, supervised examinations, clinical integration of FOCUS and self-assessed skills. Training formats were grouped as no course, basic course, or basic plus advanced course. Supervision was recorded as the number of supervised FOCUS examinations after course attendance but the survey did not distinguish between bedside instruction, joint interpretation or image review. Complete datasets were analyzed using Pearson's χ<sup>2</sup>-test and Wilson 95% confidence intervals.</p><p><strong>Results: </strong>Overall, 645 physicians participated and 469 completed the questionnaire. Senior physicians were overrepresented compared with the DGAI membership structure, whereas residents were underrepresented. More than 80% had completed at least one basic FOCUS course, yet more than 40% reported no supervised examinations before independently performing FOCUS in patients. Approximately 40% used FOCUS regularly, another 40% irregularly and 20% did not use it in practice. The FOCUS examination was used most often in emergency and intensive care situations, followed by intraoperative monitoring and preoperative evaluation. For elective preoperative assessment, cardiology was named most frequently, whereas before emergency surgery anesthesiologists were more often involved. Course participation was significantly associated with more frequent FOCUS use and supervised examinations showed an even stronger association with clinical use. Self-reported confidence in qualitative left ventricular function assessment and quantitative ejection fraction measurement increased with course level and supervision. Lack of qualification, insufficient supervision and time constraints were the main barriers.</p><p><strong>Conclusion: </strong>Despite high course participation and broad acceptance of FOCUS, the integration into perioperative practice remains limited. Courses alone appear insufficient for sustainable implementation. Supervision, continuous pra","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"618-626"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinderanästhesie zwischen Anspruch und Realität.","authors":"Frank Wappler","doi":"10.1007/s00101-026-01726-7","DOIUrl":"10.1007/s00101-026-01726-7","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":"75 9","pages":"635-637"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development of a curriculum for a fellowship in pediatric anesthesiology in Germany].","authors":"Jens Krösche, Karin Becke-Jakob, Christoph Eich, Frank Fideler, Isabel Kiesewetter, Nicolas Leister, Marcus Nemeth, Ehrenfried Schindler, Sebastian Schmid, Christoph Schramm, Katharina Röher, Christiane E Beck","doi":"10.1007/s00101-026-01704-z","DOIUrl":"10.1007/s00101-026-01704-z","url":null,"abstract":"<p><strong>Introduction: </strong>The anesthesiological care of children places particular demands on the knowledge and skills of the anesthetist providing care. There is currently no structured further training in this field in Germany.</p><p><strong>Method: </strong>A curriculum for a fellowship program in pediatric anesthesiology was developed through a consensus procedure. Building on specialist anesthesiology training this program aims to impart specific knowledge and skills for the care of children.</p><p><strong>Results: </strong>The defined final skills were divided into basic and advanced skills. Basic skills are taught at all fellowship sites, while the teaching of advanced skills depends on the structural requirements of the centers. In addition to the acquisition of clinical competencies, the fellowship comprises mandatory supplementary components, such as a quality improvement project, continuing professional development, certified pediatric emergency courses and webinars. The fellows' progress in competencies is monitored through regular, standardized evaluation interviews and documented as part of a structured evaluation. The \"Pediatric Anesthesiology Fellowship\" is a competency-based, curriculum-structured training program. Building on specialist anesthesiology training it aims to contribute to the sustainable improvement of patient safety and the quality of care in pediatric anesthesiology.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"638-648"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying predatory journals made easy: is it justifiable to apply artificial intelligence for peer review?","authors":"Raghuraman M Sethuraman","doi":"10.1007/s00101-026-01713-y","DOIUrl":"10.1007/s00101-026-01713-y","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"665-666"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Der Fall Albumin – Zeit für eine Wiederaufnahme.","authors":"Daniel Chappell","doi":"10.1007/s00101-026-01714-x","DOIUrl":"10.1007/s00101-026-01714-x","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"605-606"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anesthesiological management of adults with major burn injuries].","authors":"Johann Fontana, Björn Bliesener, Marianne Kruse, Gerd Sauermüller, Tobias Odenthal, Thorben Dieck, Stefan Trojan, Jochen Gille","doi":"10.1007/s00101-026-01703-0","DOIUrl":"10.1007/s00101-026-01703-0","url":null,"abstract":"<p><strong>Background: </strong>Due to complex local and systemic pathophysiological responses, severely burned patients present a major anesthesiological challenge.</p><p><strong>Objective: </strong>This review article summarizes the current state of knowledge and key recommendations for the anesthesiological management of adult patients with major burn injuries.</p><p><strong>Material and methods/results: </strong>The recommendations presented in this article are based on the updated S2k guidelines \"Management of thermal injuries in adults\" from September 2025 as well as on expert consensus of the Working Group on Intensive Care Medicine of the German Society for Burn Injuries (\"Arbeitskreis Intensivmedizin der Deutschen Gesellschaft für Verbrennungsmedizin, DGV)\".</p><p><strong>Conclusion: </strong>Anesthesiological management of patients with major burn injuries requires substantial clinical expertise and clear interdisciplinary communication. Core priorities include fluid resuscitation, thermoregulation, airway management and transfusion management, with close and proactive interdisciplinary collaboration being an essential factor in the perioperative management process.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"656-664"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Severe rhabdomyolysis after 3,4-methylenedioxypyrovalerone and amphetamine abuse with potential additive effect by a TASER®].","authors":"Felix Lehmann, Matthias Kamm, Filippo Ragalmuto, Mark Ulrich Gerbershagen","doi":"10.1007/s00101-026-01717-8","DOIUrl":"10.1007/s00101-026-01717-8","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"631-634"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spontaneous pneumomediastinum in a young woman].","authors":"André Thyroff, Katharina Müller-Peltzer, Joachim Bansbach, Johannes Kalbhenn","doi":"10.1007/s00101-026-01708-9","DOIUrl":"10.1007/s00101-026-01708-9","url":null,"abstract":"","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"627-630"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hereditary disorders of hemostasis in obstetrics 2/2-Anesthesiological aspects of secondary hemostasis].","authors":"F Fette, F Roll, P Kranke, J Koscielny, K Zacharowski, Christian F Weber, M-L Lindner","doi":"10.1007/s00101-026-01709-8","DOIUrl":"10.1007/s00101-026-01709-8","url":null,"abstract":"<p><p>Hemophilia A and B as well as von Willebrand diseases account for 95-97% of all congenital blood coagulation disorders and the rare factor deficiency conditions (factors I, II, V, VII, X, XI, XIII) account for the remaining 3-5%. The clinical presentation varies considerably, whereby the correlation between factor activity and bleeding phenotype is only insufficiently expressed, especially for factor VII deficiency. Pregnancy represents a special challenge as the physiological alterations of hemostasis can compensate for the underlying defect to different extents. These heterogeneous dynamics require an individualized monitoring, which also includes the individual history of bleeding as the central instrument of risk stratification, in addition to factor activities. From an anesthesiological perspective two core aspects are prioritized, the safe performance of neuraxial anesthesia procedures and the management of peripartum hemorrhage.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":"667-680"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of electroencephalography-guided general anesthesia on postoperative delirium : A meta-analysis of randomized controlled trials.","authors":"Ji-Hyeon Lee, Hyo-Seok Na, Ji-Na Kim, Jung-Won Hwang, Hyun-Jung Shin","doi":"10.1007/s00101-026-01721-y","DOIUrl":"https://doi.org/10.1007/s00101-026-01721-y","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a common and serious complication. Electroencephalography (EEG)-guided anesthesia has been proposed as a method to minimize excessive depth of anesthesia and potentially reduce the incidence of POD.</p><p><strong>Objective: </strong>This study was conducted to evaluate the effect of EEG-guided anesthesia on POD incidence.</p><p><strong>Methods: </strong>To identify relevant trials a comprehensive search across several electronic databases was performed. The primary outcome was the incidence of POD, while secondary outcomes included duration of EEG suppression and postoperative cognitive dysfunction (POCD) at 1 week and between 1 and 3 months postoperatively. Pooled relative risk (RR) and standardized mean difference (SMD) were calculated.</p><p><strong>Results: </strong>A total of 18 studies were included in the analysis. The results showed that EEG-guided anesthesia significantly lowered the incidence of POD (RR: 0.77, 95% confidence interval, CI: 0.64-0.92; p = 0.0046), demonstrating a protective effect. Additionally, EEG-guided anesthesia resulted in a significant reduction in the duration of EEG suppression (SMD: -0.57, 95% CI: -0.90 to -0.25; p = 0.0005). For POCD, no significant effects were observed at 1 week (RR: 0.54, 95% CI: 0.19-1.51) or at 1-3 months postoperatively (RR: 0.49, 95% CI: 0.20-1.18).</p><p><strong>Conclusion: </strong>The use of EEG-guided anesthesia was associated with a decrease in the incidence of POD and a significant reduction in the duration of EEG suppression; however, its impact on preventing POCD was limited. These findings suggest that although EEG-guided anesthesia can help minimize excessive depth of anesthesia, further research is necessary to identify additional strategies for reducing POD and improving long-term cognitive outcomes.</p>","PeriodicalId":72805,"journal":{"name":"Die Anaesthesiologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}